Out-of-pocket expenditure on maternity care for hospital births in Uttar Pradesh, India
Abstract Background and Objective The studies measured Out-of-Pocket Expenditure (OOPE) for hospital births previously suffer from serious data limitations. To overcome such limitations, we designed a hospital-based study for measuring the levels and factors of OOPE on maternity care for hospital bi...
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| Format: | Article |
| Language: | English |
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BMC
2018-02-01
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| Series: | Health Economics Review |
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| Online Access: | http://link.springer.com/article/10.1186/s13561-018-0189-3 |
| _version_ | 1818525972868104192 |
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| author | Srinivas Goli Anu Rammohan Moradhvaj |
| author_facet | Srinivas Goli Anu Rammohan Moradhvaj |
| author_sort | Srinivas Goli |
| collection | DOAJ |
| description | Abstract Background and Objective The studies measured Out-of-Pocket Expenditure (OOPE) for hospital births previously suffer from serious data limitations. To overcome such limitations, we designed a hospital-based study for measuring the levels and factors of OOPE on maternity care for hospital births by its detailed components. Methods Data were collected from women for non-complicated deliveries 24-h before the survey and complicated deliveries 48-h prior to the survey at the hospital settings in Uttar Pradesh, India during 2014. The simple random sampling design was used in the selection of respondents. Bivariate analyses were used to estimate mean expenditure on Antenatal care services (ANCs), Delivery care and Total Maternity Expenditure (TME). Multivariate linear regression was employed to examine the factor associated with the absolute and relative share of expenditure in couple’s annual income on ANCs, delivery care, and TME. Results The findings show that average expenditure on maternal health care is high ($155) in the study population. Findings suggest that factors such as income, place, and number of ANCs, type, and place of institutional delivery are significantly associated with both absolute and relative expenditure on maternity care. The likelihood of incidence of catastrophic expenditure on maternity care is significantly higher for women delivered in private hospitals (β = 2.427, p < 0.001) compared to the government hospital (β = 0). Also, it is higher among caesarean or forceps deliveries (β = 0.617, p < 0.01), deliveries conducted on doctor advise (β = 0.598, p < 0.01), than in normal deliveries (β = 0) and self or family planned deliveries (β = 0). Conclusions The findings of this study suggest that the OOPE on maternity care for hospital births reported in this study is much higher as it was collected with a better methodology, although with smaller sample size. Therefore, ongoing maternity benefit scheme in India in general and Uttar Pradesh in particular need to consider the levels of OOPE on maternity care and demand-side and supply-side factors determining it for a more effective policy to reduce the catastrophic burden on households and help women to achieve better maternity health outcomes in poor regional settings like Uttar Pradesh in India. |
| first_indexed | 2024-12-11T06:16:29Z |
| format | Article |
| id | doaj.art-67d6815f373b4252915b9ff540481113 |
| institution | Directory Open Access Journal |
| issn | 2191-1991 |
| language | English |
| last_indexed | 2024-12-11T06:16:29Z |
| publishDate | 2018-02-01 |
| publisher | BMC |
| record_format | Article |
| series | Health Economics Review |
| spelling | doaj.art-67d6815f373b4252915b9ff5404811132022-12-22T01:17:58ZengBMCHealth Economics Review2191-19912018-02-018111610.1186/s13561-018-0189-3Out-of-pocket expenditure on maternity care for hospital births in Uttar Pradesh, IndiaSrinivas Goli0Anu Rammohan1Moradhvaj2Room, 102 Centre for the Study of Regional Development (CSRD), School of Social Sciences (SSS), Jawaharlal Nehru University (JNU)Discipline of Economics, University of Western AustraliaRoom, 102 Centre for the Study of Regional Development (CSRD), School of Social Sciences (SSS), Jawaharlal Nehru University (JNU)Abstract Background and Objective The studies measured Out-of-Pocket Expenditure (OOPE) for hospital births previously suffer from serious data limitations. To overcome such limitations, we designed a hospital-based study for measuring the levels and factors of OOPE on maternity care for hospital births by its detailed components. Methods Data were collected from women for non-complicated deliveries 24-h before the survey and complicated deliveries 48-h prior to the survey at the hospital settings in Uttar Pradesh, India during 2014. The simple random sampling design was used in the selection of respondents. Bivariate analyses were used to estimate mean expenditure on Antenatal care services (ANCs), Delivery care and Total Maternity Expenditure (TME). Multivariate linear regression was employed to examine the factor associated with the absolute and relative share of expenditure in couple’s annual income on ANCs, delivery care, and TME. Results The findings show that average expenditure on maternal health care is high ($155) in the study population. Findings suggest that factors such as income, place, and number of ANCs, type, and place of institutional delivery are significantly associated with both absolute and relative expenditure on maternity care. The likelihood of incidence of catastrophic expenditure on maternity care is significantly higher for women delivered in private hospitals (β = 2.427, p < 0.001) compared to the government hospital (β = 0). Also, it is higher among caesarean or forceps deliveries (β = 0.617, p < 0.01), deliveries conducted on doctor advise (β = 0.598, p < 0.01), than in normal deliveries (β = 0) and self or family planned deliveries (β = 0). Conclusions The findings of this study suggest that the OOPE on maternity care for hospital births reported in this study is much higher as it was collected with a better methodology, although with smaller sample size. Therefore, ongoing maternity benefit scheme in India in general and Uttar Pradesh in particular need to consider the levels of OOPE on maternity care and demand-side and supply-side factors determining it for a more effective policy to reduce the catastrophic burden on households and help women to achieve better maternity health outcomes in poor regional settings like Uttar Pradesh in India.http://link.springer.com/article/10.1186/s13561-018-0189-3Maternal health careCatastrophic out-of-pocket expenditureHealth policy, UP, India |
| spellingShingle | Srinivas Goli Anu Rammohan Moradhvaj Out-of-pocket expenditure on maternity care for hospital births in Uttar Pradesh, India Health Economics Review Maternal health care Catastrophic out-of-pocket expenditure Health policy, UP, India |
| title | Out-of-pocket expenditure on maternity care for hospital births in Uttar Pradesh, India |
| title_full | Out-of-pocket expenditure on maternity care for hospital births in Uttar Pradesh, India |
| title_fullStr | Out-of-pocket expenditure on maternity care for hospital births in Uttar Pradesh, India |
| title_full_unstemmed | Out-of-pocket expenditure on maternity care for hospital births in Uttar Pradesh, India |
| title_short | Out-of-pocket expenditure on maternity care for hospital births in Uttar Pradesh, India |
| title_sort | out of pocket expenditure on maternity care for hospital births in uttar pradesh india |
| topic | Maternal health care Catastrophic out-of-pocket expenditure Health policy, UP, India |
| url | http://link.springer.com/article/10.1186/s13561-018-0189-3 |
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